06234 (SFD)Building
Address 54-420 Diaz
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address .
CityZip
r
Tel.
1
Contractor
Sme
Address
City
Zip
Tela
State Lic.
& Classif. 448018
City
Lic. # 1282
Arch., Engr.,
Designer
.
Address
Tel.
Validation:
City / :' /
Zip ��
State
Lic. #
I LICENSED CONTRACTOR'S DECLARATION/
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing.with Section
7000) of Division 3 of the Business and Professions Code, and my` cense is in full force and
effect- t. i
SIGNATURE `^""' DATI
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason_ (Sec. 7031.5,Bush7ess and Professions Code: Any city or county which requires a
permit to construct, after. improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a cW penalty of not more than rive hundred dollars ($500).
O 1, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such irprovements are not intended or offered for sale. If, however, the building
or improvement is sold withrl one year of completion, the owner-bugder wig have the burden
of proving that he did not build or improve for the purpose of safe.).
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date • Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Cade.)
Policy No Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished. '
I'
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (E100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California-
Date-Owner
aliforniaDateOwner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
'Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. •
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City,. State, Zip
BUILDING: TYPE CONST
A.P. Number
Legal Description
Project Description
No. 46234
OCC: GRP.
774-234-003
S. P.D.
TOTAL ,$3.509.80
REMARKS
t4
ZONE:
BY:
Minimum Setback Distances:
r
Front Setback from Center Line
Sq. Ft.
Size
No.
Stories
NO. DW.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
FINAL DATE
INSPECTOR
8/29/89
Issued by:
Date Permit
Validated by:
Validation:
Estimated Valuation
$91,593
PERMIT
AMOUNT
Plan Chk. Dep."a5.t�i(Z
Plan Chk. Bal.
.262.65
Const.
643.50
Mech.
53.50
Electrical
113.61
Plumbing
157.50
S.M.I.
6.44
Grading
20.00
Driveway Enc.
20.89
Infrastructure
2,022.60
TOTAL ,$3.509.80
REMARKS
t4
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
8/29/89
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING HEATING (ROUGH)
fj
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT.
SEWER ROUGH WIRING DUCTWORK
ROCKSTORAGE
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
POR SQ FT ®
REINF. STEEL
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE FINAL INSP.
DRAINAGE PIPING
CAR P. I SQ. FT. ®.
WATER SYSTEM
/ GRADING
FINAL INSP. /�l? cu. yd.
FINAL INSP. LLL $ plus x$
WALL SO. FT.
LUMBER GR.
DRINKING FOUNTAIN.
SQ FT ®
Q
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FIRE ZONE ROOFING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11A c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
FENCE FINAL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK / 0
GROUND PLUMBINGyai 90 UNDERGROUND A.C. UNIT
COLL. AREA
SLAB GRADE Z,0
ROUGH PLUMB. BONDING HEATING (ROUGH)
fj
STORAGE TANK
FORMS
SEWER ROUGH WIRING DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE O
GROUT
WATER HEATER SERVICE FINAL INSP.
BOND BEAM
WATER SYSTEM
/ GRADING
FINAL INSP. /�l? cu. yd.
FINAL INSP. LLL $ plus x$
_$
LUMBER GR.
FRAMING ��//l �JJ
�nV
ROOFING
Q
i �_ _�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING - pv /
MESH
INSULATION/SOUND 11
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
RECORDING REQUESTED BY
01RA114GE COAV,, TITLE GQ
AND WHEN RECORDED MAIL TO:
L,1
Name G.A.H. TRUST
street c/o Dr. Robert Harmon
Addcayr& 43-576 Washington Blvd.
State Palm Desert, CA 92210
MAIL TAX STATEMENTS TO:
1
Name
7
C]
V
C
02 W � t
,,W d �j
a V—
U. t7 Q 1 OVV C) )
o
70 3
IL W Q u G a m
W <
tu o
Street SAME AS ABOVE
Address
City &
State
LJ SPACE ABOVE THIS LINE FOR RECORDER'S USE
Grant Dee A.P.N. 773-232-017
The undersigned grantor(s) declare(s):
Documentary transfer tax is $ 10.45
( computed on full value of property conveyed, or
( ) computed on full value less value of liens and encumbrances remaining at time of sale.
( ) Unincorporated area: ( X ) City of La Quinta , and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
PHILIP DAVIS AND FLORENCE DAVIS, Trustees or Successor Trustee
of the Davis Family Revocable Trust No. 1
hereby GRANT(S) to
Hugh VM.,Harmon Trustee Under the G A H Trust dated November 29, 1986
the, foiibwing_described_r.eal.propi3t-ty_.in_the- Qity-L-Zf L4_,_Quiflt
County -of Riverside , State of California:
Lot 6, Block 95 of Santa Carmelita at Vale La Quinta, Unit No. 11
as per map recorded in Book 18 Page 75 of Maps in the Office of the
County Recorder of Riverside County, California.
Dated: November 10, 1988
STATE OF CALIFORNIA
COUNTY OF Ventura SS.
On Nor 14, 1988
before me, Mary M. E't S a Notary Public
in and for said State, personally appeared Philip Davis
and Florence Davis
(known to me) (or
proved to me on the basis of<satisfactory evidence) to he the person
whose name 5 subscribed to the
within instrument and acknowledged that they -
executed the same.
WITNESS my hand and official seal.
Signature `
Mary M. Ennis
Name (Typed or Printed)
RENCE DAVIS, Trustee
OFFICU►L SEAL
MARY- M. ENNIS
NOTARY PUaLl"AUFORNIA
VENTURACOUNTY
MQ MALI 1990
Olio area for official notarial seal)
I Title Order No. R-75002-1 Escrow or Loan No. 10-7760 I
UL -4
MAIL TAX STATEMENTS AS DIRECTED ABOVE.
G'L
4{ v„ f
O .1 v
DATE ��/ .IZ�
011 ICE OF
AGRICULTURAL COMMISSIONER
AND
WLIGI-11-5 & MEASURES
49-613 Ilwy 86, Suite 0-12
'Coachella; CA 91236
619-342,.-8291
CASE NO. i� �gClC�l
E. LEON SPAUGY
CO�rnS:�O�Eq
1M'IES 0 WALLACE
ASSISTAM r1)W.11SS1U%tR
CLEMENT 6ENVENISIE
SEALER
DEdEDOPER' S NM1E % mi C
ADDRESS:
s'7 i
_ v
Cj 220
TELEPHONE:
Dear Developer:
After reviewing your landscaping plans, all plant material listed is not in
violation of quarantine laws governing the Coachella Valley. If substitutions
do occur and they differ frun plant material listed, this office must be notified
immediately.
Thank you for protecting and preserving the -Coachella Valley's pest -free environment.
"(2
Agricultural Cotimispf6ner.ls Office
cci Indio and Riverside Office
Buena En9 ineers,' Inc.
79-811 B Country Club Drive
Bermuda Dunes, CA 92201 • (61 %345-1588
1� .. .0
Client Name
Client
Client Phone
DATE
47
JOB NO.
PROJECT
01
"� ;-4? A
ELEVATION
LOCATION (YJ
REFERENCE CURVE
CONTRACTOR
OWNER
WEATHER
TEMP.
k.
U at AM
0 at'. PM
PRESENT AT SITE
a
TEST
NUMBER
TEST LOCATION
LOT
NO.
ELEVATION
FIELD TESTING
REFERENCE CURVE
• MOISTURE
CONTENT
%
DRY
DENSITY
Ibs./Cu. ft.
MAXIMUM
DRY
DENSITY
%
MAXIMUM
DRY
DENSITY
IbsJcu. ft.
OPTIMUM
MOISTURE
CONTENT
%
r
¢
T v'a
/I dip
/
}
REM6&
<wo X e i L w 4 .:� 77i A. g
CLIENT REPRESENTATIVE SIGNATURE
r FIELD REPORT
TECHNICISIGNATURE